Sleep Disorder Clinic

Sleep-disordered breathing is an extremely common medical disorder. Obstructive Sleep Apnoea (OSA) is a common clinical problem resulting in nocturnal hypoxia and sleep fragmentation. It is characterized by repeated episodes of complete or partial collapse of the upper airway during sleep resulting in complete cessation (apnea) or reduction (hypopnea) of airflow leading to hypoxia and arousal.

It is estimated that 2% – 4% of the middle-aged population have sleep apnea. Risk factors of sleep apnea include obesity, male gender, age, smoking, hypothyroidism, acromegaly, familial factors, cranio-facial abnormalities, excessive alcohol intake and sedative intake.

Weight gain is an important risk factor for sleep apnea. It can lead to uncontrolled hypertension, increased risk for heart diseases like heart attack, cardiac rhythm disorders, heart failure, sudden death, cognitive dysfunctions, erectile dysfunction/impotence, accidents especially in those who have excessive day time sleepiness and impaired quality of life.

Symptoms of sleep apnea may also include Choking or gasping during sleep, recurrent awakenings from sleep ,Unrefreshing sleep, excessive urination at night[nocturia], Daytime fatigue, Impaired concentration, excessive daytime sleepiness, morning headache and snoring.

In sleep study monitoring, the frequency of apneas and hypopneas per hour of sleep (apnea–hypopnea index [AHI]) is the key measure to define and stratify the severity of OSA. Many studies have revealed an association between sleep apnea severity and other common causes of increased mortality such as hypertension, stroke, heart disease and occupational as well as automobile accidents. Sleep apnea is most often under diagnosed.

It mandates early recognition and treatment. Patients with snoring requires evaluation and often the first manifestation of Sleep-disordered breathing and may be associated with deleterious health effects. Conditions in which associated sleep apnea should be thought of are in those patients with poorly controlled Systemic hypertension , Obesity, Myocardial infarction, Cerebrovascular accident, unexplained Pulmonary hypertension, Type II diabetes mellitus, Nocturnal cardiac arrhythmias, Driver involved in a sleep-related automobile crash and in Preoperative anesthesia evaluation.

The diagnosis of obstructive sleep apnea is established by polysomnography, i.e., sleep study.